J Korean Med Sci.  2009 Jun;24(3):532-534. 10.3346/jkms.2009.24.3.532.

Severe Hypocalcemia Caused by Absorption of Sorbitol-Mannitol Solution during Hysteroscopy

• Lee GY
• Han JI
• Heo HJ

• KMID: 1779178
• DOI: http://doi.org/10.3346/jkms.2009.24.3.532

Abstract

Hysteroscopic procedure can be complicated by intravascular absorption of irrigating fluid. The clinical features of this complication are similar to transurethral resection of the prostate (TURP) syndrome. There have been few reports on hypocalcemia during endoscopoic surgery and clinical implications of hypocalcemia in TURP syndrome have been underestimated. We report a case of TURP syndrome association with a decreased ionized calcium concentration of 0.53 mM/L after the absorption of a large amount of sorbitol-mannitol solution during hysteroscopy. The hypotension which occurred in TURP syndrome did not respond to vasopressor and inotropic agent but responded to the administration of calcium. This case was also accompanied by hyponatremia, hyperglycemia and lactic acidosis through the metabolism of sorbitol.

Keyword

Hypocalcemia; Hyponatremia; Hysteroscopy; Sorbitol-mannitol

MeSH Terms

Female
Humans
Hypocalcemia/*chemically induced/*diagnosis/therapy
*Hysteroscopy
Intraoperative Care
Irrigation
Mannitol/*adverse effects
Middle Aged
Pulmonary Edema/radiography
Sorbitol/*adverse effects

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